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Biomedical subjects

I Kawai

Publications and source records attributed to I Kawai.

At least 37 records · Page 2Linked to original sources
PubMed1989

[A case of 18 q-syndrome associated with status epilepticus].

A 15-year-old boy with 18 q-syndrome manifesting a status epilepticus is reported. He has been already diagnosed as epilepsy because of grand mal seizures at six months earlier, and abnormal EEG findings. Unilateral status epilepticus developed at 15 years of age, which were characterized by alternative repetition of horizontal nystagmus to the right and clonic convulsion of the right (mainly upper) extremities every several minutes. Ictal EEG showed continuous 2 Hz high voltage slow waves superimposed by spikes and polyspikes which transformed to localized, irregular spike discharges in the left occipital region at the end of the status. The chromosomal study revealed a partial deletion of the long arm of No. 18. He had severe mental retardation, and a typical karyotype for 18 q-syndrome with reduced prominence of the midface region, short stature and whorls on all finger tips. The immaturity of the brain probably relates to this kind of unilateral status epilepticus.

Adolescent↗
PubMed1988

Cognitive function during absence seizures.

One patient with frequent spike-waves in EEG was studied by a neuropsychological test. The spike-waves caused an obvious prolongation of cognitive processing. This delay was considered to be caused not only by motor inhibition but also by impaired cognitive function.

Adolescent↗
PubMed1987

Treatment of childhood epilepsy with rectal valproate: case reports and pharmacokinetic study.

Two children with status epilepticus were treated successfully by the rectal administration of valproate (VPA), and complete seizure control was obtained in one patient without severe side effects. In addition, there was no essential difference in pharmacokinetics between rectal and oral administration of VPA as determined by computerized simulation of plasma concentration data of VPA after rectal administration in two healthy adults or an epileptic child. Although these findings suggest that the early absorption of VPA within 30 minutes of rectal administration is slightly more rapid than that of oral administration, rectal VPA seems to be unsuitable for the first choice in the treatment of status epilepticus, since it has not so immediate effects as intravenous administration of DZP.

Administration, Rectal↗
PubMed1984

Plasma adrenocorticotropin and cortisol responses to ovine corticotropin-releasing factor in patients with adrenocortical insufficiency due to hypothalamic and pituitary disorders.

Plasma ACTH and cortisol responses to intravenous injection of 100 micrograms synthetic ovine corticotropin-releasing factor (CRF) were studied in 4 patients with hypothalamic hypopituitarism, 2 patients with Sheehan's syndrome, 2 patients with isolated ACTH deficiency and 10 normal subjects. All 4 patients with hypothalamic hypopituitarism had exaggerated plasma ACTH responses to CRF compared to normal subjects and gradual but definite increases in plasma cortisol from low basal levels. Of 2 patients with Sheehan's syndrome, one had slight ACTH and cortisol increases after CRF injection, whereas the other had no increase in either. In 2 patients with isolated ACTH deficiency, plasma ACTH and cortisol remained undetectable (ACTH less than 10 pg/ml, cortisol less than 0.6 microgram/dl) after CRF injection. These results suggest that the CRF test is a useful tool in evaluating patients with secondary adrenocortical deficiency.

Adolescent↗
PubMed1983

Hypothyroidism associated with positive results of the perchlorate discharge test in elderly patients.

In 172 patients over the age of 55, determinations were made of thyrotropin concentrations in plasma. Although they showed such symptoms or signs of hypothyroidism as puffy face, dry skin, general malaise, cold intolerance, or constipation, there were no clinical indications of overt hypothyroidism. All the patients were apparently in a normal nutritional state, without any specific medication that might cause thyroid abnormalities. Seventeen (six men and 11 women, 9.9 percent) of the 172 patients, aged 58 to 83, had elevated plasma thyrotropin levels, ranging from 12.1 microU/ml to 170 microU/nl. To investigate the characteristics of hypothyroidism in the elderly, the perchlorate discharge test was performed in these patients. In 15 of the 17 patients, 123I thyroid uptake diminished markedly immediately after the administration of 1 g perchlorate. Thirteen of these 15 patients showed markedly diminished thyroxine (T4) levels in serum, whereas the magnitude of diminution in serum 3,5,3'-triiodothyronine (T3) values was small. Two patients with the negative discharge results showed normal T4 and T3 levels in serum. Four patients had a very small goiter, and the remaining 13 patients had no detectable goiter. Fifteen of the 17 patients had no detectable circulating thyroid antibodies in repeated determinations, and the histologic features of Hashimoto's thyroiditis were not found in the thyroid specimens obtained from two patients. These findings suggest the existence of hypothyroidism attributable to iodine organification defect without evidence of autoimmune thyroiditis in some cases in elderly patients.

Aged↗
PubMed1983

Primary generalized epilepsy and temporal lobe epilepsy: a psychological study using Rorschach tests.

Rorschach tests were performed on patients with primary generalized epilepsy (PGE) and on patients with temporal lobe epilepsy (TLE) combined with generalized tonic-clonic convulsions. Each group consisted of 20 cases and the two groups were matched as closely as possible. Patients with PGE were found to be characterized by variable responses, sensitivity, extroversion and undifferentiated tendencies. Patients with TLE are practical but inefficient and constricted in character. Cases not on medication displayed the same character types. On the basis of the above findings, speculation is made concerning the features of neurotic or psychotic PGE patients.

Adult↗
PubMed1981

Epileptic cases of late onset with the diffuse slow spike-wave.

Twenty-two cases with the diffuse slow spike-wave, whose onset of clinical symptoms was at the age of seven or later, were examined. Half of them presented symptoms pertinent to the Lennox-Gastaut syndrome. The other half were cases of absence, psychomotor seizure or grand mal. The former group was distinguished from the latter in that it had worse prognoses concerning the seizure and intelligence, and discussions were held to see if it corresponds to the "Lennox-Gastaut syndrome of late onset" (Lipinski). Atypical absence and atonic seizure were the commonest symptoms in this group, and they, preceded by other types of seizures such as grand mal, developed mostly in adolescence, and their appearance was closely followed by that of the slow spike-wave on the EEG.

Adolescent↗
PubMed1980

Uncontrollable cases of absence.

Forty-three cases of absence seizure were studied from the viewpoint of prognosis. thirty-three had been seizure-free for at least one year until the time of follow-up. The remaining 10 cases were uncontrollable and their plasma levels of the drugs were measured. The following characteristics were more significantly found in the uncontrollable group: (1) late onset (14 years old or later) (2) preceding grand mal seizures (3) accompanying automatisms. The above three factors were found to be interrelated. (4) concomitant grand mal seizures of sleep or diffuse (other than awakening) type (5) psychological disturbances (low intelligence, circuitous character) and (6) chronological shift to the Lennox-Gastaut syndrome.

Adolescent↗
PubMed1979

Three cases of unipolar delusional depression responsive to L-dopa.

We reported three cases of unipolar delusional depression which took a characteristic two-stage clinical course. Anxiety and agitation with persecutory delusions predominated the picture at first, but they were soon replaced by severe psychomotor retardation or stupor associated with delusions of poverty and guilt. The administration of L-Dopa in the latter stage brought about a rapid improvement both in mood and psychomotor activity. We considered these cases in the light of the recent biochemical studies on affective psychosis.

Adult↗
PubMed1979

Ictal body scheme disturbance induced by looking through a small opening.

The case of a patient is reported in which seizures consisting of a feeling that the left arm was absent were induced by looking through a small opening (e.g. camera view finder). The EEG showed right parietal sharp wave discharges between and during such seizures. This observation is interpreted as an example of a reflex epilepsy triggered by the specific stimulus of looking through a small opening, and involving the right parietal lobe.

Adolescent↗